HomeMy Public PortalAbout9609-9611 LONGDEN AVE_Electrical__ 76A688 CK BAGN 10/73' APPLICATION FOR ELECTRICAL PERMIT
COUNTY 012 LOS ANGELES
r DEPARTMENT OF COUNTY ENGINEER JOB
BUILDING AND SAFETY DIVISION ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
New Residential Bldgs.&Pools EACH NO. FEE NEAREST
1 &2-Family,Sq.Ft�S3 $ .025 — $ CROSS ST, s/
Multi-family Sq.Ft. 02 — OFIRM IN N MEl�j
Residential Swimming Pools '25.00 MAIL
ADDRESS
Outlets:Rec Light_Sw. CITY Tel.No.
First 20 .501 AN CHECK
Total No. Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 CITY Tel.No.
Total No. Additional '30 IT
APPLICANT
Fixed Appliances Not Over 1 HP ADDRESS
Range_Heater_D.W.— CITY j9 Tel.No
ire 7--
Oven—Dryer_W.M. 531,�!
Top —FAU —W.H._ REGNNUMBER Class.
Hood_Fan _Other— I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disp. — Room Air Cond. 2.50 THAT THE ABOVE IS CORRECT AND.AGREE TO COMPLY WITH ALL COUNTY ORDIN•
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
Up to 1 Incl. 2.50 THE LERED BY GAL OWNER OF H ABOVE DESCRIBED RESIDENTIAL ANGELESCOUNTY AND STATE OF PPRROPERTY. THAT I.AM CD
Over 1 to 10 Incl. 5.00 ) v
Over 10 to 50 Incl. 12.50 PERMITTEE .r / o
Over 50 to 100 Inc. 25.00 SIGNATOR 004
'`/
Over 100 40.00 DIST NO. Q C ED BY y
Services `J ' U V z
0-200 Amp.Under 600 V 12.50 I ECTOR"S
201.1000 Amp.Under 600 V 25.00 APPROVALS DATE NATURE
Over 1000 Amp.or Over 600 V 50.00 TEMP.POWER POLE
UNDERSLAB WORK
Temp.Power Pole&Appurtenances 10.00
10.00 ROUGH CONDUIT
Sign with One Branch Circuit 2,00
Additional Sign Branch Circuits WIRING
Misc.Conduits&Conductors 10.00 FIXTURES
Other ISee Complete Fee Schedule) POWER AUTHORIZED
UTILITY CO.NOT
AL IFIED
FIN ��,��',CI -�--p
PERMIT FEE (Sub-Total) NOTES
PLAN CHECKING FEE (One-Fourth Permit Feel
PERMIT ISSUING FEE $7.00 'I
TOTAL FEE 70,
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION < CK. M.O. CASH
1 3 .0 RAN 22 2 7 0.�• (� d9
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
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